We carried out a review of the data available to us about Chosen Services UK Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Chosen Services UK Limited, you can give feedback on this service.
Chosen Services UK Limited is a domiciliary care agency. It provides personal care to people living in their own houses or flats. The service provided support to children, younger adults and older people with learning disabilities, physical disabilities, mental health needs and sensory impairment. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection 12 people were using the service.
People’s experience of the service and what we found.
At this inspection we found the provider’s medicine policy did not reflect the needs of people who are using the service, and, medicine administration record (MAR) charts were inconsistent. We made recommendations in these areas.
People received support with their medicines from staff who were trained.
There were enough staff to meet people’s needs.
There were procedures in place for responding to accidents and incidents.
The registered manager knew when to notify the Care Quality Commission of significant events in the service.
People described staff as, "Professional and kind."
Telephone monitoring surveys were in place to monitor the running of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 01 June 2020)
Why we inspected
We undertook this targeted inspection to check a specific concern we had about medicine management. A decision was made for us to inspect and examine those risks. The inspection was prompted in part by notification of a specific incident, following which a person using the service died. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident.
We found no evidence during this inspection that people were at risk of harm from this concern.
The overall rating for the service has not changed following this targeted inspection and remains good.
CQC have introduced targeted inspections to follow up on specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ links for Chosen Services UK Limited on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
Chosen Services UK Limited is a domiciliary care agency. It provides personal care to people living in their own houses or flats. The service provided support to children, younger adults and older people with learning disabilities, physical disabilities, mental health needs and sensory impairment. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection 12 people were using the service.
People’s experience of using this service and what we found
People using the service and their relatives had no concerns about safety. Systems were in place to protect people from the risk of abuse. Risk assessments were completed to identify and manage risks to keep people safe. Staff were trained to support people to take their medicines. Measures were in place to protect people from the spread of infection. There were enough staff to meet people’s needs. Pre-employment checks were carried out to ensure staff were suitable to support people. There were procedures in place for responding to accidents and incidents.
The service carried out an initial assessment of people’s needs prior to the provision of care and support to ensure their needs could be met by the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Staff supported people to eat and drink enough to meet their needs. The service worked with other agencies to promote people’s health, safety and well-being. Staff received training and support to ensure they were competent to carry out their role.
People received care and support from staff who were caring and compassionate. People described staff as, “Kind and friendly.” Staff treated people in a respectful manner maintaining their dignity and encouraging independence. Systems were in place to protect people’s right to confidentiality. The service was respectful of people’s equality and diversity.
Care plans were person centred, included the individual needs of people, and were reviewed to reflect people’s changing needs. People were supported to pursue their interests and hobbies. Information was available in accessible formats where people required this. Complaints procedures were in place and people using the service and their relatives were confident their concerns would be taken seriously and would be addressed.
People using the service, their relatives and staff, felt the service was well managed. There was an open and transparent culture. Quality assurance systems were in place to monitor the running of the service and the effectiveness of systems in place. Feedback was welcomed to ensure continuous improvement of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 13 March 2019) and there were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Chosen Services UK Limited is registered to provide personal care to people in their own homes. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’. Where they do, we also consider any wider social care provided. At the time of our inspection, the service provided personal care to 25 people in their homes.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.
At our last inspection on 20 November 2017 the service was rated ‘Requires Improvement'. We found the service to be in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We undertook this inspection to check if the service had made the required improvements.
Previously, we found that medicines were not always managed safely. Medicine administration records were incomplete as they did not outline the name or the dose of the medicine being administered. This was a breach of Regulation 12 of the Health and Social Care Act 2008 Regulated Activities Regulations 2014 for ‘Safe care and treatment.’ During this inspection we found this breach had been addressed.
Previously we found there were insufficient systems in place to maintain an accurate and complete and record in respect of each person. Policies were not always up to date. The systems to manage staff timekeeping was not robust enough to reduce missed and late visits. This was a breach of Regulation 17 of the Health and Social Care Act 2008 Regulated Activities Regulations 2014 for ‘Good governance.’ During this inspection we found that this breach had not been fully addressed; timekeeping and policy updates were satisfactory, but we continued to find shortfalls in the systems in place to maintain accurate records about people. We also identified two further breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We found that risk assessments were not sufficient and did not ensure people were kept safe from potential harm. This was a breach of Regulation 12 of the Health and Social Care Act 2008 Regulated Activities Regulations 2014 for ‘Safe care and treatment.’
We also found that the service was not obtaining consent to care and support from the relevant person and was not complying with the principles of the Mental Capacity Act 2005. This was a breach of Regulation 11 of the Health and Social Care Act 2008 Regulated Activities Regulations 2014 for ‘Need for consent.’
The service managed medicines safely. There were sufficient numbers of staff employed by the service and people received their care on time. People using the service felt safe with their carers. Recruitment systems were robust and staff had been recruited safely. People were protected from the risk of infection. Accidents and incidents were evaluated to continuously improve the service.
The service completed pre-admission assessments to ensure the service could offer them the best support. Staff undertook regular training and received regular supervision and an appraisal to enable them to provide effective care. We found that the induction process was inconsistent; a recommendation was made to review the induction processes. People were encouraged to live a healthy lifestyle and were supported to eat well and keep hydrated. People received support from various health and social care professionals.
People were protected from potential discrimination. People and their relatives felt involved in the running of the service and could have an input into the care and support provided. People and their relatives told us staff treated people with dignity and respect and were supported to be as independent as possible.
People told us they received care that was person-centred and responsive. Individual care plans were in place but did not always have up to date details about a person. A recommendation was made to ensure people’s care plans accurately reflected a person’s current situation. Information about people’s care was not available in different formats to ensure people with different support knew about their care package. A recommendation was made to ensure the service followed best practice guidance about Accessible Information Standards (AIS). Complaints procedures were in place and records confirmed they were managed appropriately. People told us they knew how to make a complaint.
Feedback was gathered from people, relatives and staff to assess, monitor and improve the quality of the service. Staff felt valued and supported by the registered manager. The service demonstrated an open and supportive culture.
We have rated this service ‘Requires Improvement.’ You can see what action we told the provider to take at the back of the full version of the report.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of our visit there were 20 people using the service mostly from the London Borough of Barking and Dagenham.
On the day of our visit, there was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
During this inspection we found two continued breaches to regulations. This were in relation to medicines not always managed safely. Although there were quality assurance processes in place; the governance structures had not yet addressed the quality issues we identified on the day of inspection.
We made recommendations ensuring comprehensive risk assessments were in place for people.
There were safe recruitment systems in place. However we identified a few shortfalls in the training of staff. Staff although they were aware of consent and choice had limited understanding of the mental capacity act and had not always attended appropriate training.
Assessments took place before people started to use the service and were reviewed every six months. However care plans were not always specific or person centred. Daily care records did not always state the time of the visit in order to evidence that care was being delivered within appropriate timelines.
People told us they felt safe and trusted staff, who looked after them.
People and their relatives told us they were treated with dignity and respect and had had some involvement in planning their care. They told us they were able to raise complaints without any fears and thought the registered manager had tried to resolve any issues.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
Staff were able to tell us of the equipment checks in place. They had access to personal protective clothing in order to prevent the spread of infection.
You can see what action we told the provider to take at the back of the full version of the report.